加速康复外科理念下的围术期护理在老年内侧单间室膝骨关节炎患者中的应用效果

Application effects of perioperative nursing under the concept of enhanced recovery after surgery in elderly patients with unicompartmental knee osteoarthritis

目的:观察加速康复外科(ERAS)理念下的围术期护理在老年内侧单间室膝骨关节炎(UKOA)患者中的应用效果。方法:选取2020年4月至2022年1月该院收治的86例老年内侧UKOA患者进行前瞻性研究,按随机数字表法将其分为对照组和观察组各43例。两组均采取单髁置换术治疗,对照组采用常规围术期护理,观察组予以ERAS理念下的围术期护理。比较两组术后康复指标水平、手术前后膝关节功能[特种外科医院膝关节评分(HSS)、膝关节活动度(ROM)]、负性情绪[老年抑郁量表(GDS-15)]、生命质量[膝骨关节炎严重性指数(ISOA)]、术后并发症发生率及护理满意度。结果:观察组术后切口引流时间、卧床时间及住院时间均短于对照组,差异有统计学意义(P<0.05);术后1个月,观察组HSS评分和ROM均高于对照组,GDS-15、ISOA评分均低于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率为4.65%(2/43),低于对照组的18.60%(8/43),差异有统计学意义(P<0.05);观察组护理满意度为97.67%(42/43),高于对照组的81.40%(35/43),差异有统计学意义(P<0.05)。结论:ERAS理念下的围术期护理用于老年内侧UKOA患者可加快其术后康复,改善膝关节功能,减轻负性情绪,降低并发症发生率,提高患者生命质量和护理满意度。

Objective:To observe application effects of perioperative nursing under the concept of enhanced recovery after surgery(ERAS)in elderly patients with medial unicompartmental knee osteoarthritis(UKOA).Methods:A prospective study was conducted on 86 elderly patients with UKOA admitted to this hospital from April 2020 to January 2022.They were divided into control group and observation group according to the random number table method,43 cases in each group.Both groups were treated with unicompartmental knee arthroplasty.The control group was treated with routine perioperative nursing,while the observation group was treated with the perioperative nursing under the concept of ERAS.The postoperative rehabilitation index levels,the knee joint function before and after the surgery[hospital for special surgery knee score(HSS),range of motion(ROM)],the negative emotions[geriatric depression scale(GDS-15)],the quality of life[knee osteoarthritis severity index(ISOA)],the incidence of postoperative complications,and the nursing satisfaction were compared between the two groups.Results:The postoperative incision drainage time,the bed rest time and the hospitalization time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).1 month after the surgery,the HSS score and the ROM of the observation group were higher than those of the control group,the GDS-15 and ISOA scores were lower than those of the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 4.65%(2/43),which was lower than 18.60%(8/43)in the control group,and the difference was statistically significant(P<0.05).Further,the nursing satisfaction of the observation group was 97.67%(42/43),which was higher than 81.40%(35/43)of the control group,and the difference was statistically significant(P<0.05).Conclusions:The perioperative nursing under the concept of ERAS for the elderly patients with medial UKOA can accelerate the postoperative rehabilitation,improve the knee joint function,reduce the negative emotions,reduce the incidence of complications,and improve the patients’quality of life and the nursing satisfaction.